Stacey M Dorais, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

92358484405 Issued in UT

Practice address

201 S 1460 E RM 426
Salt Lake City, UT 84112-9061

Phone

(801) 581-6826

Fax

(801) 585-6816

NPI assigned

Sep 19, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Stacey M Pearson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1205262474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 1460 E RM 426",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841129061",
            "telephone_number": "801-581-6826",
            "fax_number": "801-585-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 1460 E RM 426",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841129061",
            "telephone_number": "801-581-6826",
            "fax_number": "801-585-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAIS",
        "first_name": "STACEY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "92358484405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "PEARSON",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Doordocs, LLC
• Dana Dopita, RN, MSN, CDE
• Andrew Dorais, M.D.
• Jason Dorais, M.D.
• Jessica Ashley Dorais, M.D.
• Fatemeh Dorali Beni
• Heather Doran
• Trevor Dorius, PT, DPT
• William Dorius
• Katie E Dorman

• Psychiatric/Mental Health Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.